My name is Melissa, and I’m 24 years old. I currently live in Philadelphia, which is where I was born and raised. I graduated from college a few years ago with a BA in Gender Studies and Sociology. In my free time I like to visit flea markets, bake scones, crochet, and cuddle my two adorable cats.

I think most of us associate doulas with the birth process. What does an abortion doula do?

The job of an abortion doula is to provide physical and emotional support to women terminating their pregnancies. Although doulas are more commonly associated with birth, there is also a need for empathetic supporters during abortion procedures.

How did you get into this?

I’d already been volunteering as a patient escort at the same clinic for a few years when I signed up for the abortion doula training class- I’d heard about the program and was interested, but I didn’t know if I’d be cut out for that kind of work.I signed up for the training class knowing that if it wasn’t for me, I could just not continue with the program. The main training class is about nine hours and covers everything relevant to abortions including the legislature in our state, the specifics of the procedure, and how to be a compassionate support person.

After we completed the training class (and passed the required background check/child abuse clearance), we were required to shadow another hand holder to get the full experience (it’s much different than reading about it or even watching a video). After a few shadowing shifts, when we feel comfortable, we are able to start working alone.

Can you give us an example of a normal interaction with a patient that you’re working with?

Depending on the day and how many patients the clinic has, I might see each woman for anywhere from a few minutes to upwards of 20 before the doctor actually walks in the room to begin the procedure.Usually, the doctor’s medical assistant will let me know that there’s a patient waiting in one of the procedure rooms. I walk in and introduce myself, and let her know that I’ll be with her during the procedure if that’s something she wants- most patients are open to having a support person (the patient is not allowed to bring their own support person into the procedure room; everyone besides the patient has to sit in the waiting room), but some want to be alone before the procedure.

I generally start by asking if she has any questions about the procedure, how she’s feeling, if there’s anything I can do to relieve some of her nervousness, and so on. Sometimes the patient is chatty and the conversation just carries on from there; sometimes I have to think of new topics, especially if we’re sitting for a long time waiting for the doctor. Small talk can be surprisingly difficult! Pretty much everyone likes to talk about food, since they haven’t eaten in a long time (to prep for the procedure) and are hungry.

I’ll ask about their jobs, school, holiday or vacation plans, their children if they have any, anything they want to talk about; or, if they want me there but want don’t want to talk, that’s fine, too. Once the doctor and medical assistant come in the room, the procedure starts pretty much right away and is over in just a few minutes. During that time, I will hold the patient’s hand if she’s comfortable with that, talk her through the procedure, let her know how much of the procedure is done and how much is left to go, try to make sure that’s she’s taking slow, deep breaths and doesn’t feel lightheaded.

Afterward, the medical assistant and I help the patient get dressed and walk her to the recovery room, where she’ll sit for about 15 minutes with a nurse monitoring her, until she is ready to go home. Some patients ask that I find their friend/partner/mom in the waiting room, and I’ll try and track down the person to let them know that the procedure went fine, but that’s usually the end of my interaction with the patient.

How have your patients benefited from your work?

Patients tell me that they’re glad that I was there with them during the procedure to support them. So much of the public discussion about abortion leaves out women’s experiences- it’s validating and comforting to have someone to talk to about your experience that won’t judge you for your decisions about your own body. Some women are grateful to just have someone to take their mind off things for a few minutes when they’re nervous about the procedure. Any medical procedure can be scary if you have to go through it alone, and just being able to hold someone’s hand can really help alleviate some of that anxiety.

Obviously, abortion can be an extremely emotional experience and I’m sure working in this environment can be very trying for you. How do you take care of yourself?

It can be emotionally difficult to work in this type of environment. Usually, each volunteer only works one shift per month to avoid becoming overwhelmed or burnt out. The importance of self-care was emphasized in our training, and we know that it’s okay to take a break after a particularly difficult case.I like to walk around the city for awhile and spend some time outside after a shift to clear my head. Sometimes it can be helpful to talk to friends or other volunteers about our feelings as long as no identifying information is revealed (patient confidentiality is obviously very important).

If we know someone who is having an abortion, how can we best help them work through their experience? What are some things we SHOULDN’T say or do?

I think the most important thing is to not assume how they’re feeling about the situation. Abortion is a controversial and emotional issue in our culture and it can be hard to not project our own feelings about it onto others. For some women, it is a sad, emotional experience, but many others only feel relief when it’s over. It’s best to let the person tell you how she feels. You can be supportive by listening if she wants to talk about it, offering to drive her to her appointment or to sit in the waiting room with her, make her soup afterwards, just keep her company, etc. Ask her what she needs and how you can help if she needs it.

Thanks so much for sharing your story, Melissa. Do you guys have any questions for her? Note: I realize that abortion is an extremely controversial subject. Polite, articulate disagreement is always allowed, inflammatory comments will be deleted.photo: simon cocks // cc

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22 Comments

Thanks so much for publishing this Sarah, I've read a bit about this before but it's great to get an insider's perspective.

Melissa, this must be an incredibly tough thing to do but I imagine it is also very rewarding, and very much appreciated by these women. I do have a question – I once read a really interesting (but slightly distressing) about anti-abortion campaigners who were coming in to get their own abortion, and how they reacted to it (http://mypage.direct.ca/w/writer/anti-tales.html). I just wondered if that had ever come up during your time as a doula, and, if so, how you felt about it?

I haven't personally met a patient who was also a protestor (that I'm aware of, anyway), but I know others that have. Some patients do tell me that they're against abortion but need one anyway. It's really hard to not judge people like that but I just hope the whole experience will make them more compassionate and understanding towards all women and their reproductive choices.

I had an abortion many years ago and had a very kind nurse who held my hand and comforted me. Her presence was of great help to me during a difficult moment. Thank you, Melissa for the work you so to support women.

Thanks so much for sharing this story! I've been looking into becoming a full-spectrum (birth & abortion) doula for some time now and am going to complete training for both this summer, so it's really helpful to hear from someone already doing the work.

Thank you for what you do. I had to terminate for medical reasons about a year ago. Sitting in that room by myself just before the procedure was so isolating and lonely. My husband wasn't allowed to come back with me, and it would have been nice to have someone like you there. They told me I wouldn't really remember it due to the sedation, but I do. One of the nurses held my hand, and I really appreciated that.

Gosh, reading this brought tears to my eyes. Abortion is such a personal and deeply emotional decision and the thought of there being someone there to bring some comfort and personal care to the individual who's going through it is truly a beautiful thing. Human compassion is such an important element and I am both humbled and awed at what you do Melissa. Thank you for sharing your story.

Hi Anon,I obviously can't speak for Doulas (since I'm not one) but it seems that their role is to help women by providing physical assistance and emotional support … and it seems as though that's what Melissa is doing.

Also, a prior commenter mentioned that she was looking into becoming a full-spectrum (birth & abortion) doula. To me, this indicates that the role is pretty similar for both situations.

I agree with you. The sad thing is that we’re only allowed to pat people on the back for holding someone’s hand while having an abortion but who’s holding the baby’s tiny hand? Not judging, just heartbroken. There should be someone there for him/her, too. But they die alone.

I was surprised to learn that a family member/friend/partner can't be in the room during the procedure. Is that a common practice or something that is perhaps specific to each state/clinic/etc? What is the reasoning behind that policy? Thank you for sharing!

Hi Miranda, I think that's actually pretty standard, for clinics at least. There are a few reasons for that- 1) at the clinic I work at, the rooms are on the small side and we can't physically fit another person, 2) it's important to make sure that the woman is not being forced into it by a boyfriend/husband/parent/etc, so keeping them out of the room means they can't pressure her and if she wants to not have the procedure she can tell us, 3) it's not safe to have someone without medical training in the room, in case anything should go wrong- this have never happened to me but it's a precaution. There may be other reasons or policies but those are the ones I know about.

I just saw the reply to this comment. Thank you for answering! I assumed that perhaps a possible medical complication was somehow part of the reason, but I hadn't even considered the pressuring/forcing issue. It seems so obvious now. When I had asked the question I think it just struck me as a bit cold to not allow some to be there for support, especially considering that family/friends are present for a birth at a hospital, but now that you mention that issue it makes much more sense. Thanks for sharing again!

thanks for sharing this, melissa. it makes me wish there were a similar role for other medical procedures, as most of them can be emotionally taxing. i had a biopsy for potential cervical cancer a couple of years ago, and would have loved to have a knowledgeable ally during that.

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